An interventional study of semantic learning in Developmental Language Disorder, sponsored by San Diego State University. Completed at 1 site in United States. Open to participants aged 10 Years to 12 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-12-13.
Sponsored by San Diego State University · Not applicable, Interventional, and Diagnostic
School age children with developmental language disorder (DLD) have known semantic learning deficits but what is less well understood is why semantic learning is difficult for these children. This project will combine behavioral and brain methods to investigate the cognitive and linguistic processes underlying semantic learning in children with DLD compared to typically developing peers. The outcomes will have implications for semantic learning intervention approaches in DLD.
This project will elucidate deficits in learning semantic information in developmental language disorder (DLD, formerly referred to as specific language impairment) by combining behavioral and neural measures to examine differences in the semantic learning process between school-age children with and without DLD. Vocabulary knowledge, particularly semantic knowledge, has a critical influence on reading comprehension and academic success. Despite the strong association between vocabulary knowledge and academic success, vocabulary is an under-recognized area of deficit in school-age children with DLD. Younger children with DLD have well-established deficits in vocabulary and word learning and weaknesses in semantic knowledge. Additionally, the rate of vocabulary growth in children with DLD decreases compared to typically developing peers around age 10 and semantic representations of known vocabulary items are sparse. Even with this knowledge, the field's ability to make progress toward improved semantic learning in school age DLD is hindered by the lack of basic information on the underlying nature of the semantic learning deficits in this population. This project establishes how and why semantic learning differs between school-age children with and without DLD, providing a much-needed theoretical foundation for clinical research.
Storkel, expanding on an adult word learning model by Leach and Samuel, provides a clearly testable account of word learning that has been used with children with DLD. This account involves three processes: 1) triggering, in which a new lexical encounter is compared to existing lexical representations, 2) configuration, which adds information to the expanding lexical representation, and 3) engagement, which examines how the new lexical representation behaves dynamically with existing representations. The configuration process is arguably the most critical for semantic development. Successful configuration requires the simultaneous engagement of cognitive and linguistic processes, such as attention, inhibition, working memory, and semantic and syntactic processing. While it is widely accepted that configuration is the most affected word learning process in DLD, what is unknown is what underlies deficits in configuration and whether these deficits vary across the DLD profile. These questions are further compounded by difficulty measuring configuration and associated processes, given that they are largely internal, and therefore invisible. Electroencephalography (EEG) addresses this invisibility problem by allowing for a real-time examination of unconscious levels of semantic learning and cognitive and linguistic processes. A combined EEG-behavioral methods approach can illustrate how children with DLD are approaching configuration in terms of the relative contribution of these processes. The central hypothesis of this research is that children with DLD engage cognitive and linguistic processes at different points during configuration compared to their typical peers, resulting in poorer semantic learning outcomes.
To test the central hypothesis, the investigators will record behavioral and EEG data from 10-12 year old children with DLD and typical-language peers as they complete a semantic learning task. This age aligns with the point where vocabulary growth rates in DLD further diverge from typical peers [6]. In the semantic learning task, children listen to sets of three sentences that all end with the same nonword: half of the sentence triplets support learning meaning of the nonword, half do not. The investigators will analyze EEG data for event-related potentials (ERPs) as well as changes in neural oscillations (time frequency analysis). The investigators will combine EEG and behavioral measures to examine the following aims:
Aim 1. To investigate the cognitive and linguistic processes underlying configuration in children with DLD and typical language (TL) peers. This aim will include data from the semantic learning task. Based on the assessment of behavioral outcomes, the investigators predict that the TL group will be more accurate in semantic learning than the DLD group. ERP analyses will focus on the N400 component, associated with semantic processing. Time frequency analysis will focus on changes in the theta (4-8 Hz) and alpha (8-12 Hz) frequency bands, typically associated with lexical retrieval and attention/inhibition, respectively. For both neural measures, the investigators predict engagement of the same components (N400, theta, alpha) across groups but different patterns of change in those components during configuration between groups.
Aim 2. To investigate individual differences in configuration in children with DLD and TL peers. This aim will include data from the semantic learning task and a behavioral assessment battery. Assessment of behavioral data will focus the types of errors children make during semantic learning. The investigators expect that children with DLD will provide incorrect meanings for the nonword that best fit with the first sentence in the triplet and that TL children will provide incorrect meanings that best fit with the last sentence. The investigators will also examine individual differences related to semantic learning outcomes and fine-grained differences in N400 learning effects across groups. Here, the investigators expect that individual differences in general language ability and semantic knowledge, measured via the behavioral assessment battery, will be most predictive of both behavioral semantic learning and N400 change during learning.
121 studies on the registry are indexed under Language Development Disorders; 49 are open to participants now.
This study's enrollment of 167 is above the median of 74 across 106 interventional studies indexed under Language Development Disorders.
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Exclusion Criteria:
Children with language impairment but in the absence of cognitive deficits
Other: semantic learning
Children with typical language development and typical cognitive development
Other: semantic learning
Experimental semantic learning from linguistic context task
Mean Percent Correct Semantic Meaning Identification
Accuracy on the semantic learning task. Did they correctly identify when there was a meaning or did they say there was no meaning when there should have been one (incorrect response) Higher is better outcome
Time frame: immediately following treatment, on the same day as treatment, within 30 minutes
N400 Amplitude - Sentence 1
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 1 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Time frame: immediately following treatment, on the same day as treatment, within 30 minutes
Theta Changes
Changes in theta band activity (measured in hertz) from sentence 1 to sentence 3, time locked to the final word in the sentence. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Time frame: immediately following treatment, on the same day as treatment, within 30 minutes
N400 Amplitude - Sentence 2
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 2 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Time frame: immediately following treatment, on the same day as treatment, within 30 minutes
N400 Amplitude - Sentence 3
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 3 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Time frame: immediately following treatment, on the same day as treatment, within 30 minutes
General Language Level
Full measure title: Clinical Evaluation of Language Fundamentals - 5th edition Standardized language omnibus measure Raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 80 is considered in the sub-clinical range indicating the presence of a language disorder
Time frame: baseline
Nonverbal Cognition
Full measure title: Wechsler Intelligence Scale for Children - 5th edition Nonverbal index subtests administered, considered the nonverbal subscale For the nonverbal subscale, raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 70 is considered in the sub-clinical range indicating the presence of intellectual disability
Time frame: baseline
Nonword Repetition Task
experimental task gauging phonological memory
Time frame: baseline
Participants were recruited from online sources (e.g., Craiglist, Facebook groups), word of mouth, clinical sites (on-campus Clinic, private clinics), local public schools, and the local University.
| Milestone | Developmental Language Disorder | Typical Language Children |
|---|---|---|
| Started | 15 | 97 |
| Completed | 13 | 80 |
| Not completed | 2 | 17 |
| Withdrew: Lack of efficacy | 2 | 15 |
| Withdrew: Withdrawal by subject | 0 | 2 |
Accuracy on the semantic learning task. Did they correctly identify when there was a meaning or did they say there was no meaning when there should have been one (incorrect response) Higher is better outcome
| percentage of correct responses | Developmental Language Disorder | Typical Language Children |
|---|---|---|
| Meaning condition accuracy | 73.6 ± 16.4 | 75.12 ± 14.7 |
| No meaning condition accuracy | 77.1 ± 19.5 | 82.3 ± 15.2 |
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 1 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
| microvolts | Developmental Language Disorder | Typical Language |
|---|---|---|
| N400 Amplitude - Sentence 1 | -.1 ± .002 | -.27 ± .0045 |
Changes in theta band activity (measured in hertz) from sentence 1 to sentence 3, time locked to the final word in the sentence. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
| Hertz | Developmental Language Disorder | Typical Language |
|---|---|---|
| Theta Changes | .0521 ± .478 | .121 ± .21 |
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 2 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
| microvolts | Developmental Language Disorder | Typical Language |
|---|---|---|
| N400 Amplitude - Sentence 2 | -0.1 ± 0.005 | 0.075 ± 0.003 |
Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 3 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
| microvolts | Developmental Language Disorder | Typical Language |
|---|---|---|
| N400 Amplitude - Sentence 3 | 0.221 ± .004 | .662 ± 0.07 |
Full measure title: Clinical Evaluation of Language Fundamentals - 5th edition Standardized language omnibus measure Raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 80 is considered in the sub-clinical range indicating the presence of a language disorder
| t-score | Developmental Language Disorder | Typical Language Children |
|---|---|---|
| General Language Level | 73.2 ± 11.6 | 110.9 ± 11.86 |
Full measure title: Wechsler Intelligence Scale for Children - 5th edition Nonverbal index subtests administered, considered the nonverbal subscale For the nonverbal subscale, raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 70 is considered in the sub-clinical range indicating the presence of intellectual disability
| T-score | Developmental Language Disorder | Typical Language Children |
|---|---|---|
| Nonverbal Cognition | 86.2 ± 11.2 | 106.93 ± 12.3 |
experimental task gauging phonological memory
| percent consonants correct | Developmental Language Disorder | Typical Language Children |
|---|---|---|
| Nonword Repetition Task | 83.9 ± 9.6 | 92.9 ± 5.3 |
Collected over 4 hour data collection for each participant. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Developmental Language Disorder | 0/15 (0%) | 0/15 (0%) | 0/15 (0%) |
| Typical Language Children | 0/97 (0%) | 0/97 (0%) | 0/97 (0%) |
| Age, Categorical(Participants) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| <=18 years | 15 | 97 | 112 |
| Between 18 and 65 years | 0 | 0 | 0 |
| >=65 years | 0 | 0 | 0 |
| Age, Continuous(years) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| Mean | 10 ± 1.69 | 11.7 ± 2.53 | 11.54 ± 2.54 |
| Sex: Female, Male(Participants) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| Female | 5 | 50 | 55 |
| Male | 10 | 47 | 57 |
| Ethnicity (NIH/OMB)(Participants) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| Hispanic or Latino | 4 | 14 | 18 |
| Not Hispanic or Latino | 4 | 39 | 43 |
| Unknown or Not Reported | 7 | 44 | 51 |
| Race (NIH/OMB)(Participants) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 4 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 0 | 7 | 7 |
| White | 4 | 24 | 28 |
| More than one race | 3 | 13 | 16 |
| Unknown or Not Reported | 8 | 49 | 57 |
| Region of Enrollment(participants) | Developmental Language Disorder | Typical Language Children | Total |
|---|---|---|---|
| United States | 15 | 97 | 112 |
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